Therapeutic, gravity actuated, sustained pressure applicator



July 7, 1959 M; A MULKlN 2,893,383

THERAPEUTIC, GRAVITY ACTUATED, SUSTAINED PRESURE APPLICATOR Filed MaICh 5, 1956 ATTORN )4 United States Patent Oil Ap 2,893,383 Patented July 7, 1959 .lice

a 'IIHERAIPEU'EICg AiC'IIUATEU, SUSif TztIlSIED PRESSURE APPLICA-TGR Marien Millian, KirrsvmaMa appmmonimmh issstsmai message@ 'l claim.v (c1'..1'zsfss)^ y inventiony relates'. generally to a therapeutic instrumentand, more particularlygo an: instrumentir. the application. of` therapeutic` pressure to portions ofthe human.' anatomy, especially the paravertebrali-tissuesa An, extremely effective technique for reex treatment ofl spinalfnerves involves the inhibition ofthe muscular branch of the spinal nerve and` the sympathetic chain ganglia through application of continuous pressure* of substantial magnitude to the paravertehral' tissues for a considerable. periodi of time Without' release4 or variation. The, classic manner of'performing the treatment is for the pressure to-b'e applied.Y manually t'o the-proper portions oftlie patints anatomy by the operator. administerimg the treatment. The preferred pressure is fiom about 30T to 5D" pounds depending upon the extent of tension encountered in. the patient andthepreferred' period of treatment will' similarly` vary from about 5`to 3.`5rninutes. The manualx method' has, howeven, certain obvious and significant disadvantages.` First, it is virtually impossible to maintain a continuousand'lunvaryingpressureof uniform magnitudeby manual'. means over the1requir`ed period' of'tirne. Secondlypit' is-extremely diiicult` and tiiiilg,fr the operator to attempt to" manually maintain a pressure of'themagnitude required" for a period' sufiiient to give optimumbenefit to tliepatient. Thirdly, the presence and attentionvof'y the operator,- is required continuously during the period' of`treatment. f For: these reasons,the classic or` manualf method.' of performing the mentioned" treatment has falleniiito general disuse.. Even more significantlyhowever, sincethere hasunot' been available any` fully satisfz'actoryA alternative method" or' instrument for performing the treatr'nenthe treatment itself lias fallen into di'suse',l despite the universallly recognized'beneiit's which it' can produce. whe'n properlyperformed.

Itis; therefore, the primary object ofth'isinvention to provide an instrument bywh'ich tle application of the desired; substained therapeutics pressure. mayjbe effec'- tive'ly" and conveniently, accomplisliedwithout any ofthe disadvantages"inherentiirthe manualimetlodoftreatment or ih' attempts'` to h use instruments` primarily interred;` for other'purposes.`

Reference is` nia-de tomy prior application SeliaFNo'. 3&631187, tiled Oct; 1`5`; 1953i noWlPatentNumber 238031;- 244; and entitled-` Therapeutic Gravity' Actuat'ed Sustained "Pressure Appliria-tor. The device of my' said prior application' utilizes-a number `ofthe' principles employed in this invention and is capable of operating in' a satis= factory manner'productive of "worthwhile'results From a structural standpoint; however; thev improved'present'corrstruction about' to' be described isbel'ievedtto possess many` unexpected advantages over my said" previous' irr-l vention, botli'as to safety, operating convenience"andef' tctiveness' ofiperformance Accordingly; it'vviil be utrz derstoodA thatthe present invention contemplates: certain important improvements of a structurala nature'over.` the dev-ice of my saidprevioueapplication.,

l Equipment heretofore: proposed ancldesignedfor` other purposes isA inherently illI adapted foruse or. modification to:Y achieve the. results soughtandattained-by this invention;= since` suchv prior forms ofiA equipment are'V either dangerousL to the patient,; incapable of." applying, and maintaining.' the required. pressure in thevproperfmanner, not adapted for= accuratev and: convenient adjustment-of the pressure to lie applied. to. any of. severalareaeof; the human.v body to= betreated in connection; withf diiferent a-ilments orv still`V requires the vigilantl andY substantially continuous attention of.l the operatori.

Accordingly,` it: isV anotherl important object of' the presenti invention1 to overcome. suchtk disadvantagesof prior instruments primarily intended for diiferent purposes by providingt an improved; instrument for the application of.4 therapeuticpressurm wherein,` the pressure is applied entirely bygravity actuated'` means; that auto.- matically maintains: thel pressurebeing applied` constant over anydesiredipcriodz despite respiration and-variations inthe resistancef'offeredwby the-patients tissues.` duev to descreasing muscular` tension during; treatment, and Whereinrneans are'prov-ided' for. accuratefpreselection or adjustment4 during kuse indiscreet steps-of the pressure-be? ing appliedA It may be. noted that, forthe treatment` to be. successful,v itis essential: thatf the. applied', pressure be slowly applied and released arrdsustainedlin -ste'adyrather than jerky orf uneven fashion-duringthe periodiy of treatment..

Itisanother important.objectI of the invention to pi-fovide such apparatus which will be. entirelyl safeinluse and: cannot,throughmalfunction impose an `excessive pressure which would-be iriurious,Y orfeven fatalftoithepatient, such ask might occurl throughmal-function in apparatus uttilizing. extrinsic force actuating mca'ns rather than gravity.

It` is another important object? ofthe inventionto provide. suchapparatus# which! is: of simple. natur-'e requiring practically no--maintenance and Whichf.can be quickly and l inexpensively manufactured.

Still. other important objects=ofi they inventionv including its adapatability'- for safe and.v effectiveoperationl without the. constant attendance. of. an operator, willbe ma'de clear. or become4 apparent a-s-- the following? description thereof' progresses, i it y being, noted'v that certain details: of construction are-deemed torbe signicant.

In Vthe accompanying drawing;

Fig.Y 1f is. a side elevational view-` of the entire instrument withrparts :being-f brolcehaavvay-y and. shown;l in section `for clarityoffillustration;`

Fig. 2 is a cross sectional View taken ortline II-a--ILof Figs; 1;, showing,the. pressure. applying'j assembly ofthe instrumentfronran Tend. thereof;

Fig..,3.is. a. cross ,-sectional- View taken-Ondine IIL-III ofFig.. 2;,

Fig,A 4` is affragmenta-ry cross: sectional View takenon line IS7-IV. of-.Eig. 1;:

Eig. 5'4 is..-afragmentary elevational 'View'v of the:V control means. forl a timer` device'-vvhichA may be-conveniently,v in-A stalled as a.- part .of theinstrumenuand Figr 6 is` a4 schematic representation Vofk the hydraulic portion offthew instrument.

Referring now toY the. drawingythe improved. structure contemplated by the preferred'embodiment ofthe. present. invention is generally. designatedfby, the numeral 10',,.suclnumeral'being used'to indicate the instrument as a-wlol,

Instrument includes a preferably mobile base 12, which may be mounted, for instance, upon a number of caster wheels 14. Shiftably mounted upon and protruding from the base 12 is a swingable foot pedal 16 operably connected with a liquid pump 18 for operating the latter. Base 12 houses a receptacle 20 for a supply of hydraulic fluid 22, andthe inlet of pump 18 is placed in communication with fluid 22 by a conduit 24 extending 'into receptacle 20.

Rigidly mounted upon base 12 adjacent one end thereof is anv upright, elongated, tubular, cylindrical post 26. Pump 1S, which is also housed within base 12, communicates through a conduit 28, a check valve 30 and a vconduit 32 within the inlet port 34 of a hydraulic or pneumatic cylinder 36 disposed within post 26 and provided with a piston 38 having an upwardly extending rod 40 connected thereto. The body of cylinder 36 is obviously secured to the base and post structure 12-26, while the rod 40 is free to reciprocate relative thereto.

At the uppermost end of rod 40 is secured a spider 42, which includes a number of upwardly extending arms 44 on which is supported the uppermost closed end 46 of an elongated, upright, tubular, cylindrical sleeve 48 telescopically mounted on the post 26 for vertically reciprocable, sliding movement relative to the latter.

A control valve 50 is mounted within sleeve 48 adjacent top 46 thereof, and top 46 is provided with an opening 52 for clearingna control shaft 54 coupled with the valve 50 and extending outwardly of sleeve 48 through opening 52 to a control knob 56 provided on the uppermost end of the shaft 54.

An exhaust port 58 in cylinder 36 below the piston 38 is coupled by a conduit 60 with the control valve 50 which is in turn coupled with a return conduit 62 for carrying uid 22 from the cylinder 36 back to the receptacle 20 when the valve 50 is opened. For reasons which will hereinafter become more apparent, valve 50 is preferably of the needle type so that the ow of fluid 22 from cylinder 36 may be accurately controlled and limited to a slow rate of ow.

Extending upwardly and laterally from the sleeve 48 is an arm 64, such arm 64 being either formed integrally with the sleeve 48 or secured thereto in any conventional fashion. Arm 64 includes an outermost horizontal portion 66 provided with a vertical bore 68 therethrough having a stretch of enlarged diameter as at 70. A vertical shaft 72 having an uppermost threaded portion 74 and a downturned shoulder 76 extends through bore 68, and a complementally threaded locking knob 78 is disposed above arm portion 66 upon threaded portion 74 of shaft 72. Shaft 72 is mounted for free rotation within bore 68 by a ball bearing assembly generally designated 80 having an upper race 82 press tted upon shaft 72 immediately below shoulder 76 and a lower race 84 upon which race 82 is supported by bearing balls 86. Bearing structure 80 is disposed and freely rotatable within enlarged portion 70 of bore 68 and is secured to arm portion 66 by a plate 88 underlying race 84, provided with an opening 90 for clearing shaft 72, and secured to arm portion 66 by screws or the like 92.

A yoke generally designated 94 has a neck 96 provided '-2 ii "2,893,383 f with a bore 98 into'which shaft 72 extends, neck 96 being secured to shaft 72 by a pin 100 passing therethrough. As will be apparent, when the locking knob 78 is loosened upon threaded portion 74 of shaft 72, the yoke 94 may be freely rotated relative to the arm 64; however, when the knob 78 is tightened upon thread 74 to draw the upper extremity of neck 96 into tight frictional engagement with the lowermost surface of retaining plate 88, the yoke 94 will be rigidly held in a desired position of rotation. It may be noted that the relationship between shoulder 76 of shaft 72 and the bearing assembly 80 held by plate 88 insure against dropping of the yoke 94 and its associated structure in the event that the thread 74 on shaft 72 should become stripped.

As will be most clear in Fig. l, yoke 94 is bifurcated and includes a pair of elongated, spaced, parallel legs 102 and 104 depending below the arm portion 66 in a substantially vertical direction. Adjacent their lowermost ends, legs 102 and 104 are respectively provided with openings 106 and 108 for receiving an elongated horizontal shaft 110 extending between legs 102 and 104 and through the latter.

Rotatably mounted upon shaft 110 between arms 102 and 104 is a generally rectangular, rigid, metallic plate 112 provided with a bore 114 through which shaft 110 passes. Plate 112 has a pair of major faces 116 and 118, the former being concave and the latter being convex. Secured upon concave face 116 of plate 112 is a soft, pliable layer or pad 120, which may be formed of sponge rubber. Secured upon pad 120 opposite plate 112 is a resilient, but relatively firm, layer or pad 122, which may be formed of ordinary rubber. Pads 120 and 122 conform to the concavity of face 116 presenting a slightly concave surface 124 upon pad 122 opposite the plate 112. Similarly, a soft pliable pad 126 is secured upon the convex face 118 of plate 112, and a firm, resilient pad 128 is secured upon pad 126 opposite plate 112 and having a slightly convex treating surface 130 thereon.

Plate 112 is provided with a cylindrical extension 132 adjacent leg 104, and leg 104 is provided with a laterally projecting, annular flange 134, extension 132 and ange 134 having opposed, serrated faces as at 136.

The end portion of shaft 110 passing through leg 104 is threaded as at 138 to receive a complementally threaded locking knob 140. A washer 142 upon shaft 110 between plate 112 and leg 102 is designated 142 and is held against movement longitudinally of shaft 110 by a rcotter pin 144.

As will now be apparent, when the knob is loosened upon threads 138, the shaft 110 reciprocates in the direction of leg 102 freeing the serrations 136 of extension 132 and flange 134 from each other so that plate 112 and its associated parts, which are generally designated 146 for purposes of identification, may be freely rotated upon the shaft 110 to dispose either the concave face 124 or the convex face 130 of assembly 146 downwardly or at a desired angle for contact with a patient during treatment. The convex face 130 on assembly 146 has been found particularly advantageous in treating portions of a patients body where the tissue to receive pressure are disposed within a concavity of the anatomy, while the concave face 124 possesses similar advantages for treating portions of a patients body having a substantially at or convex external contour.

When the valve 50 is closed, operation of the pump 18 by foot pedal 16 will result in uid 22 being forced into cylinder 36 to raise the piston 38 and thereby the sleeve 48 upon the post 26. As long as the valve 50 remains closed, the sleeve 48 will be retained in substantially any position of elevation upon the post 26. When, however, the knob 56 is operated to open valve 50, uid 22 will ow from cylinder 36 permitting piston 38 and sleeve 48 to descend until the assembly 146 has come into contact with the body of a patient by which the sleeve 48 will be held against further descent upon post 26. Obviously, with the valve 50 open sleeve 48 is freely slidable upwardly or downwardly upon the post 26 so that the pressure exerted upon a patients anatomy by the assembly 46 depends entirely upon the inherent weight of sleeve 48, the arm 64, the yoke 94, the assembly 146 and various other parts carried thereby including those now to be described.

At its lowermost end, sleeve 48 is provided with an internal groove 148 for receiving a complemental ange 150 upon a cylindrical, tubular weight element 152 slidably mounted upon post 26 below sleeve 48. Successive ly additional weight elements 154, 156 and 158, which are identical in construction to the element 152 are provided upon the post 26 below sleeve 48 and Weight 152,

.weight .element 1.52.1154?. 15.6.- Qr 1'5 f AS. will. @steiger training draw Theslesae 4 8 and aaah. 0f` weight elements. 15.2,. 1,-54

ggd 1,56 provided adjacent its lwei'most end with an Jeanna@ slt 1.6.4 adapted to. rslsasablr remise therein a radially extending bolt or the like 166 threadably secured in the ange portion 1'48roir 160. of the underlying .weight element 152 may be releasably secured or easily detached from the sleeve 48 to add its weight to the latter simply by lifting the element 152 to move the bolt 166 into the slot 164 and then rotating the element 152 to position bolt 166 in the horizontal portion of the slot 164. In similar fashion the weight element 154 may be releasably attached to or detached from the weight element 152, etc. It is signicant that the lowermost extremity of sleeve 48 must be spaced above the base 12 suiciently to permit the storage of any of the weight elements 152, 154, 156 and 158 in a position upon base 12 disengaged from the sleeve 48 and spaced from the lower end of the latter or the lower end of the lowermost one of elements 152, 154, 156 and 158 which is coupled with the sleeve 48. If it is desired to releasably lock the elements 152 et seq. to the sleeve 48 or the overlying one of said elements, as the case may be, the bolt 166 on the underlying element may be tightened until it holdingly engages the overlying sleeve 48 or element 152, 154 or 156. It may be noted that even ii a particular one or more of the elements 152 et seq. should be inadvertently disconnected from its overlying ysupporting structure, the patient could not be thereby injured since the pressure applied would be decreased, rather than increased.

In a preferred embodiment of the invention, the sleeve 48, arm 64, yoke 94, assembly 146 and minor parts associated therewith (excluding the weight elements 152, 154, 156 and 158) are so constructed as to have a weight of 30 pounds. The weight elements 52, 54, 56 and 58 are each formed to have a weight of pounds each. Thus, by the addition of one or more of the weight elements 152, 154, 156 and 158 by coupling same with the sleeve 48 or the next overlying weight element the aggregate weight transmitted to pressure applying assembly 146 may be conveniently and quickly varied from 30 to 70 pounds in increments of 10 pounds. Obviously, the weight elements 152, 154, 156 and 158 could be of other or differing weights to provide other incremental choices of variation.

Since the treatment to be given with the apparatus 10 is normally for a predetermined period of time, it has been found convenient to install Within the arm 64 a timing mechanism (not shown) having a bell or other alarm (not shown) as a part thereof, such mechanism being provided with an adjustment knob 170 mounted upon arm 64 for setting the time to elapse before the warning bell (not shown) alerts the attending operator to the fact that the desired time has elapsed. A graduated dial 172 is mounted upon the arm 64 for cooperation with the setting knob 170.

In operation, the sleeve 48, an appropriate number of weight elements 152, 154, 156 and 158 attached to sleeve 48, the arm 64 and assembly 146 are raised to dispose the latter at an elevation higher than the patient by the manipulation of foot pedal 16 to operate pump 18 while the valve 50 is closed. Base 12 is then shifted on wheels 14 to dispose assembly 146 over the portion of the patients anatomy to which pressure is to be applied, and the assembly 146 is adjusted in the manner previously explained to dispose surface 124 or 130 in proper orientation. Then, the valve S0 is opened slightly to permit the assembly 146 to settle slowly down upon the patient as the sleeve settles upon the post 26. As soon as the steffi-h 6 assembly 1.4.6 is .resting upon thepatienn the valve. .5.0 should. be. queried wide .to permit. absolutely free .reciproaatian of the sleeve `41.?4 upon the post 26. for reasons here ilibe explains.d..v When the period. of .treatment .is value Si)u bey ,Closed .and :the pump pedal 16 again Operated to raise the assembly 14.5` .eff the palt will now be apparent that the `appareils.desrriheii is ideally Suited fo'r accomplishing. all-.a the objects/es andoveroming. :all/ef the. 'difulties hereinbefore mem tiene'd.. It wi11a1s0he apparent. that. certainminqr modi fcations and `Changes could he made ,from the. exast structure shown and described for purposes of illustration without departing from the true spirit and intention of the invention. Accordingly, it should be understood that the invention shall be deemed limited only by the scope of the appended claims.

Having thus described the invention, what is claimed as new and desired to be secured by Letters Patent is:

l. In the therapeutic, gravity actuated, self-sustained, constant pressure applicator, a base; an upright post on the base; a sleeve slidably mounted for free vertical reciprocation on the post; a laterally extending ann on the sleeve; a patient-contacting, pressure-applying assembly on the arm and depending therefrom, said sleeve, arm and assembly being of predetermined weight, the pressure applied to the patient being developed by the ap` plicator alone solely through the action of gravity; and fluid system means for raising the sleeve on the post to lift the assembly out of contact with the patient, said means being releasable to permit free reciprocation of the sleeve on the post during treatment of the patient.

2. In a therapeutic, gravity actuated, self-sustained, constant pressure applicator, a base; an upright post on the base; a sleeve slidably mounted for free vertical reciprocation on the post; a laterally extending arm on the sleeve; a patient-contacting, pressure-applying assembly on the arm and depending therefrom, said sleeve, arm and assembly being of predetermined weight, the pressure applied to the patient being developed by the applicator alone solely through the action of gravity; and a number of tubular elements of predetermined weight circumscribing the post and adapted to be releasably coupled with the sleeve for reciprocation therewith along the post.

3. In an applicator as set forth in claim 2, wherein said elements are normally disposed in vertically stacked relationship, and there is provided means for releasably locking the uppermost element to the sleeve and each remaining element to the element immediately thereabove.

4. In a therapeutic, gravity actuated, self-sustained, constant pressure applicator, a base; an upright post on the base; a sleeve slidably and rotatably mounted on the post for free rotation and vertical reciprocation relative to the latter; a laterally extending arm on the sleeve; and a patient-contacting, pressure-applying assembly on the arm and depending therefrom, said sleeve, arm and assembly being of predetermined weight, the pressure applied to the patient being developed by the applicator alone solely through the action of gravity.

5. In a therapeutic, gravity actuated, self-sustained, constant pressure applicator, a base; an upright post on lthe base; a sleeve slidably mounted for free vertical reciprocation on the post; a laterally extending arm on the sleeve; a patient-contacting, pressure-applying assembly on the arm and depending therefrom, said sleeve, arm and assembly being of predetermined weight, the pressure applied to the patient being developed by the applicator alone solely through the action of gravity, said assembly being mounted on the arm for rotation about a substantially vertical axis; and means for releasably locking the assembly against rotation about said vertical axis.

6. In a therapeutic, gravity actuated, self-sustained, constant pressure applicator, a base; an upright post on v'the base; a sleeve slidably mounted for free vertical reciprocation on the post; a laterally extending arm on the sleeve; a patient-contacting, pressure-applying assembly on the arm and depending therefrom, said sleeve, arm and assembly being of predetermined weight, the pres- 'sure applied to the patient being developed by the approvided means for releasably locking the assembly against rotation about said horizontal axis.

References Cited in the le of this patent UNITED STATES PATENTS Miller Apr. 2, Kiracofe May 15, Schaeffer Aug. 30, Politis Mar. 1, Kelhoffer n Sept. 10,

rFOREIGN PATENTS Great Britain Feb. 15, Germany Mar. 24, 

